Abstract
Objective To classify myodural bridge complex (MDBC) in the posterior atlanto-occipital interspace (PAOiS) and posterior atlanto-axial interspace (PAAiS) in cervical spondylotic myelopathy (CSM) based on Magnetic Resonance Imaging (MRI), analyzing the effects of sex, age, spinal compression ratio(CR), space available for the cord༈SAC༉, and cervical sagittal balance༈CSB) parameters on the classification of MDBC in CSM, the aim is to provide imaging evidence for the functional research and clinical application of MDBC. Methods Imaging data from 96 patients with CSM and 104 healthy adults were retrospectively selected, were evaluated by univariate analysis of factors and multi-factor analysis of factor Influencing the MRI Classification of MDBC in CSM . Results The results showed significantly lower proportions of Type A and Type B MDBC in the CSM group than in the control group (P < 0.001), the proportions of type C and type D MDBC were greater than those in the control group (P < 0.05), and have a statistically significant correlation with age (P < 0.05), but not with sex (P > 0.05). Types C and D predominated in the MDBC classification in CSM, regardless of sex and age (P > 0.05). Parameters such as the mean subaxial cervical space available for the cord (MSCSAC), and mean subaxial cervical compression ration (MSCCR) significantly influenced the MDBC classification in CSM (P < 0.05), particularly for Types C and D. Sex and CSB did not affect MDBC classification. Conclusion The MDBC classification in CSM predominantly showed Type C and Type D, regardless of age. MSCSAC and MSCCR are influencing factors of MDBC classification in CSM, particularly affecting Type C and Type D MDB, regardless of sex and CSB.